How much rates vary
Facilitymedian $851 · 10th to 90th $288 to $871Professionalmedian $617 · 10th to 90th $501 to $6,457
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $501.19 | Facility | None | $478.63 | $478.63 | $501.19 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $501.19 Typical High $1,230.27 | Professional | None | $478.63 | $501.19 | $1,230.27 |
Ambetter Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $977.24 | Professional | None | $602.56 | $602.56 | $977.24 |
BCBS Texas Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $741.31 | Professional | None | $562.34 | $562.34 | $741.31 |
Christus Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Facility | None | $851.14 | $851.14 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $851.14 | Professional | None | $616.60 | $616.60 | $851.14 |
Lucent Health Setting Professional Modifier None Typical Low $6,456.54 Median $6,456.54 Typical High $6,456.54 | Professional | None | $6,456.54 | $6,456.54 | $6,456.54 |
Moda Health Setting Facility Modifier None Typical Low $288.40 Median $707.95 Typical High $870.96 | Facility | None | $288.40 | $707.95 | $870.96 |
Moda Health Setting Professional Modifier None Typical Low $478.63 Median $501.19 Typical High $1,230.27 | Professional | None | $478.63 | $501.19 | $1,230.27 |
Oscar Health Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | None | $3,235.94 | $3,235.94 | $3,235.94 |
Providence Setting Facility Modifier None Typical Low $288.40 Median $851.14 Typical High $870.96 | Facility | None | $288.40 | $851.14 | $870.96 |
Providence Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $851.14 | Professional | None | $616.60 | $616.60 | $851.14 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,445.44 | Facility | None | $1,230.27 | $1,230.27 | $1,445.44 |
United Setting Professional Modifier None Typical Low $446.68 Median $741.31 Typical High $1,000.00 | Professional | None | $446.68 | $741.31 | $1,000.00 |
Wellpoint Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
8 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $251.19 Typical High $309.03 | Professional | 52 · Reduced service | $239.88 | $251.19 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $100.00 Typical High $123.03 | Professional | 53 · Discontinued | $95.50 | $100.00 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $74.13 Typical High $93.33 | Professional | 55 · Aftercare only | $72.44 | $74.13 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $50.12 Typical High $61.66 | Professional | 56 · Pre-op care only | $47.86 | $50.12 | $61.66 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $251.19 Typical High $288.40 | Professional | 52 · Reduced service | $239.88 | $251.19 | $288.40 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $100.00 Typical High $117.49 | Professional | 53 · Discontinued | $95.50 | $100.00 | $117.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $74.13 Typical High $87.10 | Professional | 55 · Aftercare only | $72.44 | $74.13 | $87.10 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $50.12 Typical High $58.88 | Professional | 56 · Pre-op care only | $47.86 | $50.12 | $58.88 |
Where Texas sits
The same service costs 2.8 times more in Hawaii than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Texas· 45th of 51
$617
HI $1,514UT $550
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.